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Ask HN: Beating depression with or without anti-depressants?

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Re: Ask HN: Beating depression with or without anti-depressants?

#181
post #168
post #106

Earlier quoted context omitted.

Sorry, you are very very wrong about this. Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. Medical professionals only have one tool in their arsenal for depression: antidepressants. So a medical doctor will likely prescribe them, whether that's appropriate or not. Antidepressants are no joke. Sometimes they can help, but they…

> Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. And you think a random stranger knows any better? I know firsthand that the medical profession has serious limitations in its understanding of and ability to treat depression, but no way in hell am I taking some rando's advice over that of any of the many doctor's I've seen.

That makes no sense to me, if you're trying to deal with mental health problems and struggling you're going to be looking for new ideas from any source. Doctors are good at giving garden-variety medical advice that's validated by studies, but there's so many other ideas out there that they're not going to know about. Their background gives them expertise on what medicine says about mental health, not about the human experience itself.

Anecdotally I've been to therapists and doctors that were no help and I've read an article online [1] which was a tremendous help.

[1]: https://kajsotala.fi/2017/07/how-i-found-fixed-the-root-prob...

Re: Ask HN: Beating depression with or without anti-depressants?

#182
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6985449/ https://www.vice.com/en/article/pkeqd8/what-happens-lsd-over... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289311/

TLDR Its thought LSD sort of mimics SSRI's and locks into the serotonin receptor, but which receptor I dont know as I havent read the article and there will be a few different one's if other receptors are to go by, like histamine.

SSRI's can affect your sleep which will affect your memories and possibly your work. If you program then not being able to remember where code is could be a problem but it might not be. Escitalopram is like doing Ecstasy (MDMA) if you drink copious amounts of black tea and sugar when on them, ie you will have little E rushes throughout the day which could send your life off the rails. Melatonin besides being the sleep hormone is an anti oxidant and helps release stem cells and SSRI's can affect this hormone.

The older MAOI's maybe better, but OD on those and you will literally lights out and have no recollection of passing out. Popular with those looking to end it which is why SSRI's came to be. Problem with some of the SSRI's is they can also affect other parts of the brain which could heighten aggression and other less than desirable effects. You will reports of some SSRI's even on here https://www.erowid.org/pharms/fluoxetine/fluoxetine.shtml

I'd also look into the metals that make up various SOD's. Super Oxide Dismutase's they reduces Free Radicals and these can contribute enormously to stress, and other less than desirable effects in the body. Start with copper.

An inorganic Carbonate would probably be the only form of a metal I'd touch not chloride & sulfate, the others I would get chelated ie a metal bound to something like Glycine, which causes vasodilation and reduces inflammation , and happens to be the one chemical that has significantly increased the life span of rats more than anything else. It powers up the mitochondria.

I'd take a serious look at your diet though, your environment and even your sleep habits. Identify what it is that gets you down and see if you can resolve them. Easier said than down when considering how stubborn or criminal people can be which may be contributing your depression, but I'd start with diet and environment, and I'm not qualified in anything except my own opinion!

Re: Ask HN: Beating depression with or without anti-depressants?

#183
Right quick.

Have you tried the drugs? > Yes, Ask your doctor which doctor is best for you. I took them for about a year. It takes about a month to get it into your system, this is important.

Is my utter terror of these drugs warranted or should I just bite the bullet and try them? > Try them. Talk to your doctor. The first step for me which was the hardest, is be as open as possible to my therapist. It took me a year or so to get this going. I don't go to therapy anymore, but I am more open to those around me.

Also, if a therapist doesn't work for you, try another one. There is no reason why you need to stay with one, it is like dating, you need to find the right one.

Re: Ask HN: Beating depression with or without anti-depressants?

#184

Doctors are full of shit on this equation. Find a psychiatrist or a therapist. Exercise, read, enjoy the Sun and be busy. Do not take anti depressants.

This is awful advice, OP, please do not listen to this.

Therapist is good, exercise and sun too but the rest is so bad I really would not know where to begin.

Re: Ask HN: Beating depression with or without anti-depressants?

#185
SSRIs are really not as powerful as it sounds like you think they are. At least in the 'regular' doses I've taken, you can barely tell they're there. You've heard stories about extreme cases, which you probably won't be. And it's better to try and find out if medication helps you than go how every many more years without knowing if that's a way out.

Re: Ask HN: Beating depression with or without anti-depressants?

#186

PLEASE do not read any of these people's advice. Talk to a MEDICAL PROFESSIONAL, preferably a DOCTOR. DO NOT trust your mental health to strangers on the internet, be it reddit, or hacker news, or whatever. If you are based in the US and live nearby a university they usually have good counseling services and the infrastructure to refer people even if you're not attending the school. Search "{school} counseling servic…

I think the reason you are getting so many "I disagree" responses is because many of us have had awful experiences when it comes to medical professionals and mental health.

It's important to understand the economic pressures in psychiatry. I went to see a psychiatrist, who prescribed me antidepressants. They helped give be a baseline level of energy to get me out of my acute depression, but they addressed none of my underlying issues that caused me to get depressed in the first place, and a couple years later I was right back in the depths again. And I'm fine if my dr's economic model meant he couldn't do psychotherapy with me, but he never recommended I get therapy, and that's what I'm so bitter about regarding him.

I've heard it said that giving antidepressants to a depressed person, without any therapy, is like giving amphetamines to a tired person: yes, they may temporarily cure your "tiredness", but what you really need is to go to sleep.

So while I don't think OP should take detailed advice from random strangers, he should be aware of his options. Talk to a therapist first to see if they can uncover what some of the root cause issues are. Be open to medication - some mental issues really are largely organic in nature, but a good doctor and therapist will know they are just one tool to improve your mental health.

Re: Ask HN: Beating depression with or without anti-depressants?

#187
post #106

Earlier quoted context omitted.

Sorry, you are very very wrong about this. Have you ever talked to a _medical_ professional about depression or any mental health issue? They generally don't know what they're doing. Medical professionals only have one tool in their arsenal for depression: antidepressants. So a medical doctor will likely prescribe them, whether that's appropriate or not. Antidepressants are no joke. Sometimes they can help, but they…

> Sometimes they can help, but they can also cause really strange side effects, like increasing the possibility of suicide FWIW, my understanding is this has little to do with the drugs and mostly to do with the recovery process. In a deep depression, you might have suicidal thoughts, but lack the will to take action on those thoughts (because depression takes away your motivation). As you a person comes out of depre…

In the beginning of SSRI consumption, it causes initial 5HT2C upregulation and activation, which can directly cause feelings of anxiety, dread, hopelessness, and restlessness/akathisia[1]. Over time, however, the body down regulates 5HT2C in response to its activation, and those symptoms tend to dissipate.

In a way, yes, there can be feelings induced that can provide the motivation and energy to go through with suicidal thoughts, but those unpleasant emotions aren't exactly triggered by an inherent will to die. Those who experience akathisia sometimes feel like the only way to rid themselves of the feeling is to end their lives.

I point this out because it might seem, or feel to those experiencing it themselves, that those suicidal thoughts are organic and what the person really wants, but they tend to be exacerbated directly by medication and can get better with time. I also point it out because there are ways to sidestep 5HT2C activation with different medications or combinations, it doesn't necessarily have to be inevitable.

[1] https://en.wikipedia.org/wiki/Akathisia

Re: Ask HN: Beating depression with or without anti-depressants?

#188

Have you looked into non-pharmacological treatments like tDCS or rTMS? brain stimulation is safe and often as effective as drugs but without the side-effects. https://pubmed.ncbi.nlm.nih.gov/30917990/

*when used within timing, voltage, and montage guidelines

Fisher Wallace for the higher powered more-supervised insurance-covered version.

I think if you get to magnetic stimulation then IV Ketamine has similar raw costs but less time and better success rates.

That said tDCS has helped me when I get negative-value spirals and I need to suppress/quiet that part of the brain a bit.

Re: Ask HN: Beating depression with or without anti-depressants?

#189

Honestly: go and talk to a doctor you trust. My opinion (not a doctor): What is wrong in your life? Are you: + Working too hard + Commuting + Not exercising and taking care of yourself + Eating a diet with lots of processed foods + Using drugs and alcohol as a crutch + Overweight + Not resting regularly + Sleeping poorly + Have other health issues not addressed + Without genuine friends + Without a good partner + A c…

As another person who has struggled with depressive issues at various points in my life, I really like your list. I have ticked every one of those boxes at one time or another; all of them brought me down, took effort to fix, and improved my well-being when fixed.

Including having children?

Re: Ask HN: Beating depression with or without anti-depressants?

#190

If you want to avoid SSRIs, you can try ketamine treatment. Should be able to find it in most major cities now. In my city the cash price is about $400/a session and you probably need 2-3 sessions. Pros: if it works you will start to feel better in just a few days, and you only have to get a few 2-4 hour treatments a year. Cons: hard to get insurance to pay for it, SSRI are cheaper. https://www.health.harvard.edu/blo…

Ketamine is good and it's nice to see the recommendation but you are wayyyyyyy low on your numbers haha.

Minimum induction that basically every clinic follows is the 6 session schedule.

From there the standard is to slowly taper down to once every 4-6 weeks. Some patients cannot taper and so need more constant.

For example, I'm more "Ketamine resistant" so I was on 2 weeks for a while, then 3, then about a year in I made it to 4, 5, then 6 with the help of doctor prescribed at home dosing.

About $10,000-$12,000 out of pocket for a year's worth of infusions for me. Saved my life and turned it around, so totally worth it.

Also...the spiritual benefits. I think that alone, having that seed planted is invaluable. To me.

But for nearly everyone the effect wears off after 4 weeks (hence the need for a response w/ Ketamine). So it's what one does over a few years to shift their brain superstructure that I think weans them off. And all that BDNF + everything else flying around in there haha.

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